Pediatric cardiology
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Pediatric cardiology · Jan 1997
Case ReportsDiagnostic dilemma: left aortic arch with right descending aorta--a rare vascular ring.
An infant had a rare type of vascular ring comprising a left aortic arch, a retroesophageal transverse aorta, a right descending aorta, and a right ligamentum arteriosum. Noninvasive studies including echocardiography with Doppler color flow mapping and magnetic resonance imaging were diagnostic of a vascular ring. However, only angiography prospectively established the exact type of ring. This report discusses the pitfalls of noninvasive studies used to diagnose unusual arch anomalies.
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Pediatric cardiology · May 1996
Noninvasive evaluation of systolic pressures of pulmonary artery and right ventricle using contrast-enhanced doppler echocardiography: comparative study using sonicated albumin or glucose solution.
Evaluation of pulmonary arterial pressure is essential for the diagnosis and management of patients with congenital heart disease; it is usually done by cardiac catheterization. An alternative, noninvasive method may be clinically more useful. The purpose of this study was to assess the usefulness of the noninvasive determination of systolic pressure of the pulmonary artery and right ventricle by contrast-enhanced Doppler echocardiography. ⋯ The transtricuspid pressure gradients obtained by continuous-wave Doppler during sonicated albumin enhancement corresponded closely to those measured by cardiac catheterization (r = 0.95). Pulmonary arterial and right ventricular systolic pressures measured by Doppler using sonicated albumin and those obtained by cardiac catheterization were highly correlated (right ventricle, r = 0.96; pulmonary artery, r = 0.95). In conclusion, this technique may be a valuable noninvasive method for determining accurate right ventricular and pulmonary arterial systolic pressures.
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Pediatric cardiology · Mar 1996
Case ReportsPerinatal manifestations of idiopathic long QT syndrome.
A neonate who had presented with sustained irregular heart rate during labor was found to have QT prolongation and repetitive polymorphic ventricular tachycardia (torsades de pointes) postnatally. Propranolol and propafenone successfully controlled the ventricular arrhythmias. ⋯ On propranolol monotherapy the boy is thriving and completely free of ventricular arrhythmias. In the rare case of long QT syndrome in the neonate, early detection and therapy are mandatory to prevent ventricular arrhythmias and sudden death.
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Pediatric cardiology · May 1995
Case ReportsCritical tricuspid regurgitation secondary to ruptured chordae tendineae mimicking a mass on the tricuspid valve in a newborn.
Tricuspid regurgitation (TR) due to chordal rupture is a rare condition in newborns. We present a newborn with critical TR. ⋯ Histopathologic examination revealed collagen degeneration and calcification in the ruptured chordae, producing the hyperechoic image. It should be emphasized that ruptured chordae of the tricuspid valve might mimic a tricuspid valve myxoma or a thrombus on cross-sectional echocardiography.
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Pediatric cardiology · Jan 1995
Case ReportsMalignant wide complex tachycardia after adenosine administration to a postoperative pediatric patient with congenital heart disease.
Adenosine has become the treatment of choice for paroxysmal supraventricular tachycardia because of its safety and efficacy. There have been no reports of malignant arrhythmias occurring after adenosine administration. This case report presents the occurrence of a malignant wide complex tachycardia after intravenous adenosine administration in a 10-year-old boy 2 days after a Fontan procedure. Thus the administration of adenosine in a critically ill postoperative patient can have morbidity or potential mortality and must be monitored closely.